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目的:探讨种植过程中或上颌窦提升时上颌窦黏膜意外穿孔的对策。方法:2003～2010年间,17例上颌后牙区骨量不足的患者,种植过程中或上颌窦提升时上颌窦黏膜意外穿孔。3例放弃种植;其余14例,采用种植体突入上颌窦内1.0～1.5 mm种植,同时进行骨引导再生技术加高牙槽嵴1.5～2.0 mm。结果:14例成功完成种植义齿修复,随访1～8年,种植均获成功。结论:只要上颌窦无炎症,术中上颌窦黏膜意外穿孔没有进一步扩大,种植体突入上颌窦内1.0～1.5 mm,进行种植是安全的;通过骨引导再生技术结合骨粉加高牙槽嵴1.5～2.0 mm,总体可增加约2.5～3.5 mm的高度,对上颌窦底距牙槽嵴顶约有4～7 mm高度者,无须在上颌窦黏膜意外穿孔情况下放弃种植。
Objective: To discuss the strategy of perforation of maxillary sinus mucosa during implantation or maxillary sinus ascending. Methods: From 2003 to 2010, 17 patients with maxillary posterior teeth lacking bone mass were implanted perforate the maxillary sinus mucosa during implantation or maxillary sinus ascending. Three patients gave up their implantation. The remaining 14 patients were implanted with 1.0-1.5 mm implants into the maxillary sinus, while bone regeneration was used to raise the alveolar ridge 1.5-2.0 mm. Results: Fourteen patients successfully completed the implant denture repair. All the patients were successfully treated for one to eight years. Conclusion: As long as there is no inflammation in the maxillary sinus, the accidental perforation of the maxillary sinus mucosa does not expand further. The implant protrudes 1.0 ~ 1.5 mm into the maxillary sinus and is safe for implanting. Through the bone-guided regeneration combined with bone meal, 2.0 mm, the overall increase of about 2.5 ~ 3.5 mm height, the maxillary sinus from the alveolar crest about 4 ~ 7 mm height, without the accidental perforation of the maxillary sinus in the case of giving up planting.